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This lecture is not a separate lecture given by the doctor but it is an introduction to prosthodontics and an orientation to laboratory and

clinical steps that are covered by this course . Lets start with some important definitions

Definitions:

Prothesis (:) Replacement of lost body part the prostheses : plural of prosthesis Prosthetics: science and art that deal with prostheses Dental prosthetics is called prosthodontics : ) ) replacement of loss oral tissues related to oral cavity . Prosthodontist :person who specializes in prosthodontics. Complete Denture (CD) : dental prosthesis that replaces all missing teeth and associated structures . Edentulous: patient with no teeth (.) Partially edentulous: patient with some teeth missing. Dentate: still have teeth.

Complete Denture : deals with edentulous patients ONLY


In prosthodontics there is a strong and important relationship between the lab and the clinic and to be able to understand this course well you have to distinguish and know this relationship very well Now we need to start with divisions of Prosthodontics : Prosthodontics is divided into

prosthodontics

Fixed prosthodontics
*the restoration cant be removed from its place by patient . Ex.(crowns and bridges)

Removable prosthodontics The restoration can be removed from its place by patient . *actually it should be removed from its place every day to get cleaned .

Implant prosthodontics

Maxillofacial prosthodontics *here we dont replace missing teeth or gums we replace missing structures

Conventional fixed Crowns and bridges

Complete denture
*when we have no teeth at all in the patients mouth all teeth are missing.

Partial denture
*where we have missing and remaining teeth .not all teeth missing

An immediate denture delivered at the same day of extraction.

Acrylic partial denture

An Over denture rests on 1.remaining roots of un extracted natural teeth *notice not remaining teeth remaining roots . 2.implants

Chrome-cobalt partial denture

Can rest on implants

Or roots of natural teeth

Now we will talk about clinical and laboratory steps First of all you should know that making a complete denture requires 5 visits minimum ideally if you were lucky and things went smoothly and you dont have to repeat steps .. Some private clinics skip a visit or two and this is questionable if they get the best results or not !! and most likely they dont

First visit history examination and primary impression

clinic 1. History taking 2. Clinical examination 3. Primary impression making using : Alginate

OR

Impression compound *we get moderately accurate impression *in primary impression we use stock tray.

lab 1.Poring the impression using gypsum type 2 plaster We get primary casts moderately accurate On the primary casts we 2.fabricate special trays using: Cold cured acrylic

OR

Light cured acrylic *we get special or custom trays.

Second visit secondary impression

1. Boarder
moulding using green stick compound. 2. Secondary impression taking using zinc oxide eugenol impression material

OR 3.rubber impression material.


*we take secondary impression using custom made tray . *we get more accurate impression. 1. taking measurements of patents face and mouth which means recording the relationship between teeth and face specifically for our patient . 2. bite registration which means recording how my patient bites . Try-in we try the record blocks with the teeth set on wax and check for: Esthetics phonetics and Occlusion

1.Pouring secondary impression using type 3 gypsum (dental stone) we get secondary casts on secondary casts we 2.fabricate record blocks *record blocks are composed of: 1. base plate made from light cured acrylic resembling denture base 2. wax rim on the base plate occupying the place of the future teeth

Third visit jaw relation record

1. mounting the
record blocks that are sealed together on an articulator to make my self an exact replica of the patients mouth . 2. teeth setting which includes removing parts of the wax and putting the acrylic teeth in its place . Processing which is a type of lost wax technique replacing wax with acrylic. Processing includes: a. Flasking b. Dewaxing c. Packing d. Curing e. Deflasking f. Finishing and polishing of the denture

Fourth visit try-in

Fifth visit delivery

Delivery that means giving the denture to your patient telling him how to wear it and also again checking esthetics phonetics and occlusion .

If the denture needs a type


of modification that cant be done in the clinic you can return it to the lab for modification. *usually we dont need this step as most modifications at this stage can be done chairside (in the clinic)

Sixth visit recall

You have to review your patient to see how is the denture in function meaning in chewing and talking etc.. *90-95% of patients satisfied at delivery will have complaints at recall.

The end